Development and evaluation of a wellbeing structural model for health sciences students

Van Zyl, Reinette (2019-12)

Thesis (MCom)--Stellenbosch University, 2019.

Thesis

ENGLISH SUMMARY : Health sciences students experience a great amount of personal distress throughout their training. This has potential adverse effects on their professionalism, competence, academic performance, and personal wellbeing. For instance, studies have found medical students to have a higher rate of depression and suicidal ideation than their age-matched peers. Students adopt various coping mechanisms to manage this stress, and often these coping mechanisms are maladaptive. These challenges have consequences for our society as a whole: not only does South Africa have a shortage of healthcare professionals, but if these issues remain unresolved, they can endanger the lives of health sciences students and seriously jeopardise patient care. It is thus essential to take a deeper look at the wellbeing of health sciences students in order to solve the dilemma. The focus of past industrial psychology literature on the wellbeing of health sciences students has typically highlighted the negative aspects of wellbeing, such as burnout. This is understandable, as burnout is a major area of concern, especially amongst health sciences students. However, one cannot help but be curious why some health sciences students do not develop burnout, regardless of high job demands. Instead, they may experience a sense of academic engagement. These students are better able to cope than their peers under highly demanding and stressful work conditions. The following research-initiating question is therefore the driver of this study: “Why is there variance in the wellbeing (engagement and burnout) of health sciences students at Stellenbosch University?” The job demands-resources (JD-R) model (Bakker & Demerouti, 2018) was used as a framework to investigate the wellbeing of health sciences students at Stellenbosch University. The primary objective of this study was to develop and empirically test a partial structural model to portray the network of variables that affect the wellbeing (engagement and burnout) of health sciences students at Stellenbosch University (based on the JD-R model). The antecedents comprise social support (as a job resource), mindfulness and emotional intelligence (as students’ personal resources), and work overload (as a job demand), which are present in a health sciences education environment. An ex post facto correlational design was used to test the formulated hypotheses within this research study. Quantitative data was collected from 357 health sciences students by means of non-probability convenience sampling. A self-administered voluntary web-based questionnaire was sent to Stellenbosch University health sciences students. The measuring instruments consisted of (a) the 14-item Utrecht Work Engagement Scale-Student Survey (UWES-S) (Schaufeli, Martínez, Pinto, Salanova, & Bakker, 2002a), (b) the 15-item Maslach Burnout Inventory-Student Survey (MBI-S) (Schaufeli et al., 2002a), (c) a seven-item social support scale devised by Susskind, Kacmar, and Borchgrevink (2003), (d) the 15-item Mindfulness Attention Awareness Scale (MAAS) (Brown & Ryan, 2003), (d) the 14-item Genos Emotional Intelligence Inventory (Genos EI) (Palmer, Stough, Harmer, & Gignac, 2009), and (e) the eight-item overload subscale within the Job Demands-Resources Scale (JDRS) (Rothmann, Mostert, & Strydom, 2006). The data was analysed using item analyses and structural equation modelling (SEM). A partial least squares (PLS) path analysis was conducted to determine the model fit. From the 11 hypotheses formulated in the study, five of the paths were found to be significant, though only four supported the JD-R theory. It is important to note that four of the insignificant paths were related to the moderating effects (the fifth being significant, but not supporting the JD-R theory – hypothesis 11). Hypotheses 3 and 4 were also found not to be statistically significant. Nevertheless, hypotheses 1, 2, 5, and 9 were all found to be statistically significant and supported the JD-R theory (Bakker & Demerouti, 2018). Additional paths were also found that could contribute to an extension of the JD-R theory. The findings of the study shed light on the importance of interventions that can foster job resources and personal resources in the pursuit of optimising health sciences student wellbeing, especially in the face of high demands.

AFRIKAANSE OPSOMMING : Gesondheidswetenskapstudente ervaar ’n hoë mate van persoonlike nood tydens hulle opleiding. Dít het potensiële nadelige uitwerkings op hulle professionaliteit, bevoegdheid, akademiese prestasie en persoonlike welsyn. Byvoorbeeld, studies het gevind dat mediese studente ’n hoër persentasie van depressie en selfmoord-ideasie het as hulle eweknieë van dieselfde ouderdom. Studente gebruik verskeie behartigingsmeganismes om hierdie stres te hanteer, en dikwels is hierdie behartigingsmeganismes wanaangepas. Hierdie uitdagings het gevolge vir ons samelewing as ’n geheel: nie net het Suid-Afrika ’n tekort aan gesondheidswerkers nie, maar as hierdie probleme onopgelos bly, kan dit ook die lewens van gesondheidswetenskapstudente in gevaar stel en pasiëntsorg ernstig in gedrang bring. Dit is dus noodsaaklik om die welsyn van gesondheidswetenskapstudente beter te ondersoek ten einde die dilemma op te los. Die fokus van vorige bedryfsielkundige literatuur oor die welsyn van gesondheidswetenskapstudente het tipies die negatiewe aspekte van welsyn, soos uitbranding, uitgelig. Dít is verstaanbaar, omdat uitbranding ’n belangrike bron van kommer is, veral onder gesondheidswetenskapstudente. ’n Mens kan egter nie help om nuuskierig te wees oor waarom sommige gesondheidswetenskapstudente nie uitbranding ontwikkel nie, ten spyte van hoë werkvereistes. In plaas daarvan kan hulle ’n gevoel van akademiese betrokkenheid ervaar. Hierdie studente is beter in staat as hulle eweknieë om baie veeleisende en stresvolle werksomstandighede te hanteer. Die volgende navorsingsinisiërende vraag is dus die drywer van hierdie studie: "Waarom is daar variansie in die welsyn (betrokkenheid en uitbranding) van gesondheidswetenskapstudente aan die Universiteit Stellenbosch?" Om op hierdie navorsingsinisiërende vraag te kan reageer, is die job demands-resources (JD-R) model (Bakker & Demerouti, 2018) gebruik as raamwerk spesifiek om die welsyn van gesondheidswetenskapstudente aan die Universiteit Stellenbosch te ondersoek. Die primêre doelwit van hierdie studie was om 'n gedeeltelike strukturele model te ontwikkel en empiries te toets om die netwerk van veranderlikes wat die welsyn (betrokkenheid en uitbranding) van gesondheidswetenskapstudente aan die Universiteit Stellenbosch (gebaseer op die JD-R-model) beïnvloed. Die spesifieke voorafgaande veranderlikes wat in hierdie studie getoets is, was maatskaplike ondersteuning (as ’n werkshulpbron), bewustheid en emosionele intelligensie (as studente se persoonlike hulpbronne), en werkoorlading (as ‘n werkseis) wat in 'n gesondheidswetenskappe-onderrigomgewing voorkom. 'n Ex post facto korrelasie-ontwerp is gebruik om die geformuleerde hipoteses binne hierdie navorsingstudie te toets. Kwantitatiewe data is by 357 gesondheidswetenskapstudente versamel deur middel van nie-waarskynlikheidsgeriefsteekproefneming. ’n Self-geadministreerde vrywillige webgebaseerde vraelys is aan die Universiteit Stellenbosch se gesondheidswetenskapstudente gestuur. Die meetinstrumente bestaan uit (a) die 14-item Utrecht Work Engagement Scale-Student Survey (UWES-S) (Schaufeli et al., 2002a), (b) die 15-item Maslach Burnout Inventory-Student Survey (MBI-S) (Schaufeli et al., 2002a), (c) a sewe-item social support scale van Susskind et al. (2003), (d) die 15-item Mindfulness Attention Awareness Scale (MAAS) (Brown & Ryan, 2003) (d) die 14-item Genos Emotional Intelligence Inventory (Genos EI) (Palmer et al., 2009), en (e) die agt-item werkoorlading subskaal binne die Job Demands-Resources Scale (JDRS) (Rothmann et al., 2006). Die versamelde data is deur middel van item-analise en strukturele vergelykingsmodellering geanaliseer. ’n PLS roete-ontleding is onderneem om modelpassing te bepaal. Uit die 11 hipoteses wat in die studie geformuleer is, is vyf van die paaie gevind om statisties beduidend te wees, maar slegs vier het die JD-R-teorie ondersteun. Dit is belangrik om daarop te let dat vier van die onbeduidende paaie verband hou met die matigende effekte (die vyfde is beduidend, maar ondersteun nie die JD-R-teorie nie – hipotese 11). Hipoteses 3 en 4 was ook nie statisties beduidend nie. Tog is hipoteses 1, 2, 5 en 9 almal statisties beduidend en ondersteun hulle die JD-R teorie (Bakker & Demerouti, 2018). Bykomende paaie is ook gevind wat kan bydra tot die uitbreiding van die JD-R-teorie. Die bevindings van die studie werp lig op die belangrikheid van ingrypings wat werkhulpbronne en persoonlike hulpbronne kan koester in die strewe om gesondheidswetenskapstudente se welsyn te optimaliseer, veral wanneer werkseise hoog is.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/107011
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